| NPI | 1760719306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELICIA STALLWORTH Director 347-677-6422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: NY 9408L001) |
| Enumeration Date | 2009-11-03 |
| Last Update Date | 2009-11-03 |